Few clinics and high demand

More on religious interference with medical treatment in Washington state:

For years, religiously affiliated hospitals have merged with secular health care systems, often with disruptions to services like reproductive health care. About half of health care systems in Washington are affiliated with religious organizations, which means that even with state-level and national protections for abortion, hospitals in Washington can deny or restrict reproductive health care based on religious protocols. The result is a patchwork of reproductive health policies that vary by hospital, and can leave patients confused or without care altogether.

It’s bizarre. It’s also evil and infuriating, but the bizarreness is puzzling. I don’t understand why they’re allowed to do this. I don’t think engineers get to design defective bridges “based on religious protocols,” and I don’t see why medical care is different. Medicine is technical; religion has nothing to do with it.

The U.S. Conference of Catholic Bishops’ Ethical and Religious Directives, a set of theologically rooted guidelines for Catholic health care institutions, prohibit abortion entirely, but their limitations extend far beyond elective abortion, complicating a number of routine treatments and procedures. For example, if a patient has an ectopic pregnancy — a nonviable pregnancy that occurs when a fertilized egg develops outside the uterus — the directives forbid any intervention that includes an abortion. But termination, either through medication or surgery, is the only treatment for ectopic pregnancy. If left untreated, ectopic pregnancy can cause the fallopian tube to rupture, which is a life-threatening medical emergency. 

In other words Catholic bishops (by definition all men, of course) give themselves permission to kill women because of their “religious protocols.” It shouldn’t be allowed. The bishops should be in prison.

While some hospitals that don’t provide abortion care will refer patients elsewhere, a referral may not be possible in an emergency. In 2013, a Washington woman almost died at PeaceHealth St. Joseph Medical Center in Bellingham after being denied treatment for an infection following a miscarriage. Cases like hers, reported by Rewire News Group and documented by the ACLU, led the state Legislature to pass the Protecting Pregnancy Act in 2021. The law allows doctors working in institutions under the Catholic Church’s purview to override ethical-religious directives in the event that a medically necessary abortion is required. “Patients were in these situations, some of them very dire, and they were having their care delayed or denied, which is unacceptable,” said the ACLU’s Rutman.

To put it mildly.

Even before the rise of hospital mergers, the American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists documented a number of cases across the country in which patient outcomes were adversely [affected] by providers’ refusal to participate in reproductive health care. The professional organization has been clear in advocating that reproductive health care be upheld when hospitals merge, citing concerns about physicians’ ability to care for their patients. 

“Where reproductive health care services are prohibited, health care providers are put in the difficult position of having to withhold needed care until patients’ conditions deteriorate to a point at which care is permitted,” said the group in a position statement on reproductive health care restrictions, including those at religiously affiliated institutions. “Ultimately, the health of women and quality of the patient-physician relationship suffer.”

Because guess what, sometimes patients’ conditions deteriorate so much that they die before the doctors are finally allowed to treat them. Oops.

The state’s Reproductive Privacy Act ensures that even if Roe is overturned, abortion would remain legal in Washington state. But the confusion comes at a time when the state’s reproductive health care infrastructure is already strained, especially in areas where there are few clinics and high demand resulting from out-of-state patients. While 18 health centers provide abortion in and around the greater Seattle area alone, just 11 health centers operate east of the Cascades, only three of which are full-service clinics providing both onsite surgical and medication abortion in Yakima, Kennewick and Spokane.

The state east of the Cascades is huge geographically, and tiny in terms of population.

Clinics across the state are preparing to accommodate a growing influx of patients from states like Idaho, whose residents already routinely seek abortion care in Washington. While elected officials have pushed the idea that Washington will become even more of a haven for patients seeking abortions in world without Roe v. Wade, expanding actual capacity for care beyond those five clinics on the eastern side of the state would be complex, with so many of the state’s hospital beds under religious control.

This is the result of years of hospital mergers that have weakened the state’s ability to provide adequate reproductive health care. The true extent of that weakness will soon be determined if Roe v. Wade is overturned.

Check.

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